TITLE:
Relationship between Positive Glucose Screening, Obesity and Pregnancy Outcome in the Absence of Gestational Diabetes: A Retrospective Cohort Study
AUTHORS:
Kassam Mahomed, Sharleen Young, Ibinebo Ibiebele, Jane V. Hoare
KEYWORDS:
Positive Glucose Screening Test, Gestational Diabetes, Obesity and Pregnancy Outcome
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.9,
June
24,
2014
ABSTRACT: Background: Currently pregnant women
with abnormal glucose screening test (GCT), performed at 26-28
weeks gestation with a subsequent normal glucose tolerance test (GTT) receive
routine care. Could these women be at risk of adverse pregnancy? Objective:
Compare rate of caesarean section (CS), induction of labour (IOL), macrosomia,
admission to special care nursery and neonatal hypoglycaemia. Designs:
Retrospective cohort study. Setting: Ipswich Hospital, Ipswich, Queensland.
Participants: Pregnant women having had the test at the hospital laboratory.
Methods: Charts review of outcome measures including induction of labour,
caesarean section, macrosomia, RDS and short-term neonatal morbidity. Results:
We reviewed 882 charts (441 cases and 441 controls). There was a higher IOL
rate among cases 21.1% versus 16.6% (OR and 95% CI 1.45; 1.03-2.06)
and a higher CS rate, 30.4 versus 23.6 (OR and 95% CI 1.41; 1.05-1.91).
Compared to women with BMI 18.5 - 24.9, women with BMI of 30 and above had a
significantly higher IOL rate (47.1% versus 22.6%), higher CS rate (47.2%
versus 25.7%) and higher rate of macrosomic baby (79.2% versus 4.2%). There
were more women amongst the cases who were older, smoked, had a BMI 30 and
above and had previous history of GDM. After adjusting for maternal age, BMI
and smoking status, there was still an increased odds of CS, IOL and
macrosomia, but this did not reach statistical significance. Conclusion:
Abnormal glucose screening test in the absence of gestational diabetes is
associated with adverse pregnancy outcome. This is largely contributed by
maternal obesity.